Reidual: Is diagnosed when displays of prominent symptoms stop.Hallucination ,delusions or idiosyncratic bahaviours may still be present. Manifestation significantly diminished.

Custodial care or employment/active family life.Most have waxing,waning course marked with hospitalisations, some assistance from outside support.Higher level of functioning before=better outcome,vice versa. Women have a better prognosis for higher function.

Undifferentiated/ other: Symptoms are not formed enough/specifically to fit into other subtypes-symptoms can fluctuate. Other people will exhibit symptoms that are remarkably stable over time but still may not fit one of the typical subtypes.

Paranoid: The defining feature is auditory hallucinations or prominent delusional thoughts about prosecution or conspiracy.They do not show these symptoms until later life.They appear to have normal lives and may not act or appear in an unusual manner.

The hallucinations and delusions revolve around a characteristic theme that remains fairly constant over time. The temperament and behaviours correlate to the content of the thought. Due to the degree of paranoia or suspiciousness, people are very reluctant to discuss these issues with a stranger.

If the symptoms are in a phase of worsening there may be some disorganisation of the thought process,rouble with speaking coherently,memory and generally behaving in a disorganised, irrational manner. Paranoid schizophrenics only come to the attention of mental health professionals after a very stressful event that increases the symptoms.

Definitions.

Feature -Is usually a statistic or fact about the illness.E.g. after an initial episode between 14-20% of people will fully recover.

Social withdraw -Avoiding meeting up with friends and family,not going out.

Delusions -A false fixed belief based on false or incomplete information which can effect a person's perceptions of events.

Thought disorders -When a person finds it difficult to concentrate,become muddled and may become disorganised making it hard to understand what they are talking about.

Apathy -Lack of interest, enthusiasm or concern about anything.

Hallucinations -False or distorted sensory experiences that appear to be real perceptions such as seeing or hearing something that is not actualy there.

Symptom -A characteristic displayed through their behaviour,emotions and thoughts.E.g. Hallucinations.

Positive symptom -When something is added to your bahaviour or personality that was not there prior to the illness.E.g. Hallucinations and Delusions.

The biological explanation suggests that schizophrenia is caused by having an excess number of dopamine receptors and the neurons that use the transmitter 'dopamine' fire too often and transmit too many messages.

This is thought to be the reason for schizophreia as lowing the DA(dopamine) activity helps to remove the symptoms of schizophrenia. This can be done through Chlorophromazine a drug given to schizphremics to block the D2 receptores.

Also amphetamines (agnists) lead to an increase of DA levels.If theses drugs were given in a large enough quantity they can lead to hallucinations and delusion two common symptoms of schizophrenia and if these drugs were given to schizophrenics there present positive symptoms would worsen.

Parkinson's sufferers have low levels of dopamine and therefore require L-Dopa (Levodopa) to raise it up to healthy levels,however too much of it will lead to schizophrenic symptoms.

The dopamine hypothesis focuses on the mesolimbic (which leads to positive symptoms) and the mesocortical pathway (that leads to negative and cognative symptoms) found in the cortex.

Falkai et al (1988)

Autopses have found that people with schizophrenia have a larger than usual number of dopamine receptors.Including an increase of DA in brain structures and receptor density (left amygdala and caudate nucleus putamen).It was condluced that DA production is abnormal for schizophrenia.

Linstroem et al (1999)

Radioactivity labelled a chemical L-Dopa.

Administered to 10 patients with schizophrenia patients.

L-dopa taken up quicker with schizophrenia patients.

Concluded that DA production is abnormal for schizophrenia.

Studies.

Falkai et al (1988)

Autopses have found that people with schizophrenia have a larger than usual number of dopamine receptors.Including an increase of DA in brain structures and receptor density (left amygdala and caudate nucleus putamen).It was condluced that DA production is abnormal for schizophrenia.

Linstroem et al (1999)

Radioactivity labelled a chemical L-Dopa.

Administered to 10 patients with schizophrenia patients.

L-dopa taken up quicker with schizophrenia patients.

Concluded that DA production is abnormal for schizophrenia.

Meltzer et al (2000)

Looked at the effectiveness of drug treatment used placebos or established anti-psychotic drug called haloperidol.Foud that after 6 weeks that haloperidol gave significant improvements compared to placebo.

Strengths.

Gave people with schizophrenia placebo or haloperidol. Those on the latter showed significant improvement compared to control.

Effecftive in treating the symptoms of schizophrenia.

Angrist et al (1980)

Dopamine inhibiting medicines take a few days to work. Shows reductionism of treatment.

Pickar et al (1992)

Compared effectiveness of Clozapine with other neuroleptics and a placebo.

Clozapine was the most effective in treating symptoms. The placebo was the least effective.

Supporting Evidence for the Dopamine Hypothesis.

Amphetamines and other drugs can cause excess dopamine receptors,reducing the symptoms of schizophrenia as excess dopamine is avoided.

Those with schizophrenia have different brains (such as grey matter differences in the front and temporal lobes). These brain changes especially in an early age,link with a sensitivity to dopamine.

Schizophrenics are more sensitive to dopamine then normal people based on a test where amphetamines where given.

Phenothiazines are a group of drugs that block dopamine receptors,reducing the symptoms of schizophrenia.

Genes that are likely to increase sensitivity to dopamine are found with a greater frequency then in normal people.

Animal studies (Schwabe et al 2004) have shown that if an animal is sensitised to PCP (angel dust) it is also sensitised to dopamine.The dopamine receptors are also increased.

Amphetamines only produce positive symptoms.

Patients of 10 years show that (via pet scan)drugs that block dopamine did not reduce the symptoms.Even if the block was 90% effective however if anti-psychotic drugs are administered early on in the disorder,then more than 90% of patients respond.

Social and environmental factors are also involved,something stressful in the patients life may have triggered the excess dopamine release.The biological explanation is not sufficient.

Although anti-psychoic drugs that block dopamine receptors almost immediately the calming effects are not noticed for several days.This suggests something else is causing the psychotic symptoms.

Freeman (19940 Evidence of immigrants with higher levels of schizophrenia in host country.Due to stressors experienced when moving and automatic lower socio-economic status.

Does not agree with the biological explanation.

Treatment.

CBT.

CBT works on helping the patient to recognise the symptoms and find ways to cope with them and therefore may offer a more long-term treatment than drug therapy,that will stop working if the patient stops taking the drug (which they often do).

Weaknesses.

It requires between 15-20 sessions with a trained therapist and therefore is expensive and time consuming.

Willis (2006) sugguests that one of the downfalls of CBT is that there is a lack of trained therapists in the uk who can effectively deliver CBT.

Garety et al (2008), did not find any evidence of effectiveness of CBT in reducing relapse,and sugguests that this may have been due to too much focus being placed by cognitive behaviour therapists on targeting positive psychitic symptoms of schizophrenia while neglacting the emotional distress associated with these symproms.

Cognitive treatment- evaluation, supporting studies and strengths.

Kane et al (1996)- up to 40% of schizophrenia sufferers have poor response to anitipsychotic drugs and continue to show moderate to severe psychotic symptoms.

Pilling et al (2002)- carried out a meta analyisis of family intervention and CBTand found that CBT significantly improves both positive and negative symptoms.

Gould et al (2001)- found that compared with pharmacological therapy, the drop out rates for CBT are very low at 12%.

Tai and Turkington (2009)- summerised the results of CBT studies and found that it has been effective in both clinical and research settings.

They also found that positive symptoms respond to CBT but acknowledged that CBT is not as effective when people do not view themselves as being ill.

Paranoid: The defining feature is auditory hallucinations or prominent delusional thoughts about prosecution or conspiracy.They do not show these symptoms until later life.They appear to have normal lives and may not act or appear in an unusual manner.

The hallucinations and delusions revolve around a characteristic theme that remains fairly constant over time. The temperament and behaviours correlate to the content of the thought. Due to the degree of paranoia or suspiciousness, people are very reluctant to discuss these issues with a stranger.

If the symptoms are in a phase of worsening there may be some disorganisation of the thought process,rouble with speaking coherently,memory and generally behaving in a disorganised, irrational manner. Paranoid schizophrenics only come to the attention of mental health professionals after a very stressful event that increases the symptoms.

Looked at the effectiveness of drug treatment used placebos or established anti-psychotic drug called haloperidol.Foud that after 6 weeks that haloperidol gave significant improvements compared to placebo.

Strengths.

Gave people with schizophrenia placebo or haloperidol. Those on the latter showed significant improvement compared to control.